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Norvir Advisory

Taste Masking
from Presentation 4, Norvir Community Update

Exerpt from Presentation 4, Norvir Community Update - Robert Dintruff, Marketing Manager, Abbott International

PRACHAR: At this point, we would like to discuss our taste masking study.

We went to the Arthur D. Little consulting firm which has significant experience in taste masking strategies for products that, after they were formulated, were not pleasant enough for patients to take on a consistent basis. We know there are many anecdotes on how to mask the taste of liquid Norvir. We decided to systematically go through all the categories of options, and then, with all of the examples possible, identify what we found to be the best things to help with the taste of Norvir in the interim. What I mean by categories is - do you prime your mouth with an agent and then take the Norvir? Is that better than chasing it with an agent after you swallow it? Is that better than mixing it with some other liquid form and creating a higher volume of liquid that's diluted? Is that better than injecting it with a syringe and squirting in the back of the throat, to bypass the taste buds? Those were categories of options that we monitored or that we evaluated.

The consulting firm has a panel of experts - called an expert sensory panel - that tests products and tolerability options for pharmaceutical and consumer products. They are not quite wine connoisseurs, but they do this over and over again. So they started with the flavor profile of Norvir. They analyzed all of the principal elements that make Norvir taste the way that it does. They picked out specific attributes about the Norvir flavor profile. They found the flavor unbalanced and the various flavor elements are not cohesive. They identified a peppermint taste, a caramel taste, a medicine taste, and an alcohol bite. All those things together create an unpleasant tasting product.

So what can we do, based on their expert opinion, to identify a reasonable set of options that might mask this unpleasant taste, knowing what we know about these types of negative attributes? That was step one. Step two was testing from 50 to 75 options that, based on their experience, they thought might work well. They found out that many things that we thought worked real well, didn't work so well. And some other things that we had a hunch might work well for various reasons, did work well. What we ended up with was a list of six products that we tested with HIV-positive patients that were taking Norvir to find out which of the products helped mask the taste for them. And these are the results.

These are the top performing chasers from #1 to #4: Number 1 is Nutella hazelnut spread which is somewhat like peanut butter, a little bit thinner in consistency, but with a chocolate hazelnut spread on top of graham crackers. And just a side note, the consulting firm tried to test products that are available globally, because we realize that these conclusions would need to be applicable to a global audience. We also looked for things that would be portable, meaning that they wouldn't have special storage requirements and might be able to be carried easily. We also looked for diversity, in terms of if people are taking a dose at breakfast and evening, we didn't want to just have foods that might be appropriate for the end of day and no one would ever take for breakfast.

QUESTION: What are graham crackers?

DINTRUFF: It is a cookie, or a biscuit , with the consistency of a cracker. However, it's sweeter than a cracker.

PRACHAR: And a rationale for it being globally available is that it is a Nabisco brand name, which is a very global brand, and there are multiple others. That was the top one. Number 2 was Riessen chocolate chew.

QUESTION: That's globally available?


QUESTION: In Canada?

PRACHAR: We can follow up specifically on a country-by-country basis, but we gave the firm the charter to look at things that are globally available.

QUESTION: I think Riessen's are made by Nestle.

PRACHAR: Riessen's are made by Nestle, so that's reason to believe that they are are available most places.

QUESTION: What do they look like?

PRACHAR: They are little chocolate squares that have the consistency of a little piece of fudge. They are individually wrapped. So you can put them in your pocket and carry them with you. What is important to remember is that this was an expert panel that picked these products and then tested them with Norvir patients. Taste is a very individualized thing. This study has statistical reliability in that we surveyed enough patients to believe that this is a broadly generalizable list. But if you know for certain that other things have worked with specific patients, do not tell them to discontinue what they are doing. Do whatever works.

Number 3 is a simple oats and honey granola bar. We have all seen these. There are several different brands that are individually packaged and very popular. Number 4 was cracker sandwiches with peanut butter. Just simple tiny cracker sandwiches with peanut butter in between. There are several brands. They are very popular and you can find them in most vending machines. These are the top four products in global distribution that the consultants and patients found most helpful.

DINTRUFF: You will know better than we will what works in a relatively short period of time to mask the taste of Norvir in people in which the taste is a problem.

Posted 12/28/98

Notice: This is an IAPAC initiative that is under the sole direction of the IAPAC Norvir Advisory Committee. Contents of the Norvir Advisory section of the IAPAC Web site are subject to the approval of the chair of the advisory committee and will reflect the recommendations of the committee members. Abbott Laboratories has no input in the content of the Norvir Advisory section of the IAPAC Web site.